JAMA Neurol:隐匿性血管性脑损伤MRI指标的临床意义

2018-10-25 zhangfan MedSci原创

研究发现,隐匿性血管性脑损伤MRI指标具有重要的临床意义

老年人群中隐匿性血管性脑损伤(VBI)非常普遍,但其临床和治疗意义尚存在争议。近日研究人员就VBI的临床意义进行考察,对最常见的与年龄相关的神经疾病,脑卒中和痴呆的预防策略进行优化。

研究人员对1966-2017年间PubMed收录的相关研究进行检索,考察了4种隐性VBI-MRI标志(血管来源的白质高强度[WMH]、MRI定义的隐匿性脑梗死[BIs]、脑微出血[CMBs]以及血管周围间隙[PVSs])与中风,痴呆以及死亡的相关性。

94个相关研究纳入本次荟萃分析,其中WMH患者14529人,BI患者16012人,CMB患者15693人,PVS患者4587人。WMH导致中风(HR=2.45)、缺血性中风(HR=2.39)、脑内出血(HR=3.17)、痴呆(HR=1.84)、AD(HR=1.50)以及死亡(HR=2.00)风险增加。MRI-BI导致中风(HR=2.38)、缺血性中风(HR=2.18)、脑内出血(HR=3.81)以及死亡(HR=1.64)风险增加。CMB与中风(HR=1.98)、缺血性中风(HR=1.92)、脑内出血(HR=3.82)以及死亡(HR=1.53)风险增加。PVS相关研究有限,不足以进行Meta分析,但认为高PVS负担与中风、痴呆和死亡的风险增加有关,但需要确认。

研究发现,隐匿性血管性脑损伤MRI指标具有重要的临床意义。

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    2019-07-24 yinhl1978
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